Agranulocytosis caused by ticlopidine and its mechanism.

Abstract:

:A 75-year-old female patient with agranulocytosis caused by ticlopidine is reported. She took the drug at 200 mg/day for 30 days to prevent recurrence of cerebral infarction. The leukocyte count at the nadir was 500/microliters on the 34th day since she started to take the drug. Complete recovery of her peripheral leukocytes came 12 days after its withdrawal. In this patient, mechanisms of ticlopidine-caused agranulocytosis were studied. The lymphocyte stimulation test using ticlopidine was negative. In the culture of marrow cells depleted of lymphocytes, ticlopidine directly inhibited the CFU-C in a dose-dependent manner. Neither the serum on the day of admission nor the T-lymphocytes pre-cultured with ticlopidine had any effect on the CFU-C. The lymphocyte stimulation test is useless in an attempt to find the causal drug in agranulocytosis if it is caused in a directly toxic manner. Agranulocytosis caused by ticlopidine is rare, but careful follow-up is necessary in the case of patients on the drug because there are some whose marrow cells are very sensitive to it.

journal_name

Am J Hematol

authors

Ono K,Kurohara K,Yoshihara M,Shimamoto Y,Yamaguchi M

doi

10.1002/ajh.2830370405

subject

Has Abstract

pub_date

1991-08-01 00:00:00

pages

239-42

issue

4

eissn

0361-8609

issn

1096-8652

journal_volume

37

pub_type

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